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Complete Video Index

Want to sort, search, and spot a specific video to watch by procedure, keyword, category or author? Download the Video Archive Navigator​ tool, and use Excel functionality to find and click through to the videos you want. The database is updated monthly with each new issue of PRS. Special thank you to Donald Lalonde, MD and Kaitlin Boehm, MD for creating and maintaining the Video Archive Navigator.

Video demonstrates the technique of precise and complete release of the tear trough ligament and the origins of the orbicularis oculi. The dissection was performed as atraumatically as possible by utilizing the ‘dissection through the facial soft tissue spaces’ approach. From "The Long-Term Static and Dynamic Effects of Surgical Release of the Tear Trough Ligament and Origins of the Orbicularis Oculi in Lower Eyelid Blepharoplasty." Plastic and Reconstructive Surgery: September 2019 - 144(3).

Last year, over 100 thousand American women had breast reductions. And it’s no surprise: macromastia- or overly large breasts- can cause psychosocial issues and severe back pain. Even though macromastia can affect women from the onset of puberty, performing breast reductions in women under 21 is still considered to be controversial by some, due to potential minor complications.

In this video, Rod J. Rohrich, MD, Editor-in-Chief of "Plastic and Reconstructive Surgery," discusses a new study which investigates the safety and outcomes of breast reduction surgery for adolescents and young women.

Read the September 2019 PRS #PlasticSurgery article, "Complications and Quality of Life following Reduction Mammaplasty in Adolescents and Young Women," by Nuzzi, Firriolo, Pike, DiVasta, and Labow.

For consumer information on plastic surgery, and to find a board-certified plastic surgeon in your area visit http://plasticsurgery.org

Cryopreservation is widely used to deep-freeze bloodless tissues for clinical practice, but could it be used to salvage and replant a human finger? Rod J. Rohrich, MD, Editor-in-Chief of "Plastic and Reconstructive Surgery," discusses how plastic surgery researchers from China cryopreserved two patients’ amputated fingers for extended time periods and managed to reattach them successfully.

Just like the tread on a car tire, the fat under your heels or toes can wear down over time. This is called "fat pad atrophy," and it affects about 30% of people over the age of 60. Rod J. Rohrich, MD, Editor-in-Chief of "Plastic and Reconstructive Surgery," discusses how plastic surgeons can use fat grafting to relieve foot pain for patients suffering from fat pad atrophy.

Video demonstrates Mesh Abdominoplasty with medial resection of rectus muscle along with pre and post-operative exams. From "Appreciation of post partum changes of the rectus muscles in primary and re-do abdominoplasty." Plastic and Reconstructive Surgery: August 2019 - 144 (2).

Video demonstrates an animated overview of the face transplant. From "Facial Transplantation for an Irreparable Central and Lower Face Injury: A Modernized Approach to a Classic Challenge." Plastic and Reconstructive Surgery: August 2019 - 144 (2).

Video demonstrates the technique of precise and complete release of the tear trough ligament and the origins of the orbicularis oculi. The dissection was performed as atraumatically as possible by utilizing the ‘dissection through the facial soft tissue spaces’ approach. From "The Long-Term Static and Dynamic Effects of Surgical Release of the Tear Trough Ligament and Origins of the Orbicularis Oculi in Lower Eyelid Blepharoplasty." Plastic and Reconstructive Surgery: September 2019 - 144(3).

Last year, over 100 thousand American women had breast reductions. And it’s no surprise: macromastia- or overly large breasts- can cause psychosocial issues and severe back pain. Even though macromastia can affect women from the onset of puberty, performing breast reductions in women under 21 is still considered to be controversial by some, due to potential minor complications.

In this video, Rod J. Rohrich, MD, Editor-in-Chief of "Plastic and Reconstructive Surgery," discusses a new study which investigates the safety and outcomes of breast reduction surgery for adolescents and young women.

Read the September 2019 PRS #PlasticSurgery article, "Complications and Quality of Life following Reduction Mammaplasty in Adolescents and Young Women," by Nuzzi, Firriolo, Pike, DiVasta, and Labow.

For consumer information on plastic surgery, and to find a board-certified plastic surgeon in your area visit http://plasticsurgery.org

Cryopreservation is widely used to deep-freeze bloodless tissues for clinical practice, but could it be used to salvage and replant a human finger? Rod J. Rohrich, MD, Editor-in-Chief of "Plastic and Reconstructive Surgery," discusses how plastic surgery researchers from China cryopreserved two patients’ amputated fingers for extended time periods and managed to reattach them successfully.

Just like the tread on a car tire, the fat under your heels or toes can wear down over time. This is called "fat pad atrophy," and it affects about 30% of people over the age of 60. Rod J. Rohrich, MD, Editor-in-Chief of "Plastic and Reconstructive Surgery," discusses how plastic surgeons can use fat grafting to relieve foot pain for patients suffering from fat pad atrophy.

Video demonstrates Mesh Abdominoplasty with medial resection of rectus muscle along with pre and post-operative exams. From "Appreciation of post partum changes of the rectus muscles in primary and re-do abdominoplasty." Plastic and Reconstructive Surgery: August 2019 - 144 (2).

In this video, Dr. Steven Fagien, MD, FACS discusses the article "Assessing Retrobulbar Hyaluronidase as a Treatment for Filler-Induced Blindness in a Cadaver Model" by Paap, Milman, Ugradar, and Silkiss, which appears in the August 2019 issue of Plastic and Reconstructive Surgery, Volume 144 Issue 2.

Since the first successful face transplantation, the plastic surgery science behind this amazing procedure has continued to grow and evolve to produce better and better outcomes. In this video, Rod J. Rohrich, MD, Editor-in-Chief of "Plastic and Reconstructive Surgery," discusses the science, precision, and collaboration needed to perform one of the most recent face transplantation surgery operations."

Rod J. Rohrich, MD, Editor-in-Chief of "Plastic and Reconstructive Surgery," discusses an artificial intelligence face recognition software developed by plastic surgeons to precisely measure emotions such as contempt, disgust, and even joy. This AI may help surgeons better assess if reconstructed smiles are conveying true emotion.

We are in the midst of an important public discussion about the safety of silicone breast implants. In this video, Rod J. Rohrich, MD, Editor-in-Chief of "Plastic and Reconstructive Surgery," discusses "silicone implant illness" and the latest scientific evidence on breast implants.

Total or near-total nasal loss can have devastating effects. Plastic surgeons can help. In this video, Rod J. Rohrich, MD, Editor-in-Chief of "Plastic and Reconstructive Surgery," discusses the efficacy and outcomes of the ‘radial forearm flap’ used to reconstruct people’s noses.

Read the July 2019 PRS #PlasticSurgery article, "Microvascular Reconstruction of the Nose with the Radial Forearm Flap: A 17-Year Experience in 47 Patients" Salibian, Menick, and Talley.

For consumer information on plastic surgery, and to find a board-certified plastic surgeon in your area visit http://plasticsurgery.org

LSD (Lateral Skin-platysma Displacement) is a technique to treat platysma bands and anterior skin laxity without a submental incision. Evolution of the technique together with important issues and resolutive suggestions are discussed like: how to avoid cheese-wiring, how to carry out an effective platysma dislocation and anchoring, and how to treat excess cervical fat. Lateral approach to submandibular gland reduction can be performed through the lateral approach with great advantages as time saving, reduced risks and avoidance risk of airways compressing hematoma.

Fat grafting is an essential tool in all of plastic and reconstructive surgery. In this video, Rod J. Rohrich, MD, Editor-in-Chief of "Plastic and Reconstructive Surgery," discusses the difference between platelet-rich plasma (PRP) and platelet-rich fibrin (PRF) and their benefits in fat grafting.

This video demonstrates patient selection, aesthetic analysis and surgical planning for an isolated neck lift with lipofilling. This procedure is indicated in the relatively young patient who demonstrates cervical laxity but only early signs of facial aging. The video demonstration emphasizes approaches to platysmaplasty, accurate contouring of cervical fat, the technique of lateral platysma window with preservation of the great auricular nerve as well as considerations for contouring the jawline and lower third of the cheek. The technique of autologous fat injections to correct facial deflation is demonstrated.

This video demonstrates patient selection, aesthetic analysis and surgical planning for an isolated neck lift with lipofilling. This procedure is indicated in the relatively young patient who demonstrates cervical laxity but only early signs of facial aging. The video demonstration emphasizes approaches to platysmaplasty, accurate contouring of cervical fat, the technique of lateral platysma window with preservation of the great auricular nerve as well as considerations for contouring the jawline and lower third of the cheek. The technique of autologous fat injections to correct facial deflation is demonstrated.

The biologic effect on facial soft tissue following the injection of Hyaluronic Acid (HA) fillers are still being investigated, but the clinical effects suggest more than just volume replacement. Reconstituting HA fillers at low concentrations utilizing lidocaine allows these injectable agents to be placed superficially with fine gauge needles to improve the appearance of fine lines. The long-term effects of reconstituted HA fillers on fine lines clinically suggests both a volumetric as well as a regenerative biologic effect, as wrinkle ablation in many patients is apparent months to years following injection. This video discusses both the technique and efficacy of utilizing reconstituted low concentration HA fillers for facial rejuvenation.

Many techniques have been described for treating macromastia. This lecture focuses on the technical details related to several commonly utilized methods including the inverted-T Wise pattern technique, the vertical mammoplasty, and the SPAIR procedure. Technical details and results are presented, including a technique for the prevention of "bottoming out."

This surgical video outlines the markings, technical details, and results for a patient undergoing a short scar periareolar inferior pedicle reduction mammoplasty. There is a particular emphasis on the detailed surgical maneuvers required for success.

This surgical video outlines the markings, technical details, and results for a patient undergoing a short scar periareolar inferior pedicle reduction mammoplasty. There is a particular emphasis on the detailed surgical maneuvers required for success.

In this video Drs. Rod Rohrich and Steve Fagien demonstrate and discuss the finesse and precaution needed for safe and effective combined use of neuro-modulators and hyaluronic acid reversible fillers in the nose, cheeks, lips, mid-face, brow, and temple areas.

The roles of proper lighting, sterile technique, and use of conservative volumes in all areas -especially the lips and cheeks- are emphasized to allow for a natural, not-overdone outcome.

High definition liposuction has become an integral part of our technique for abdominoplasty, enhancing both abdominal contour and postoperative muscular definition. This video demonstrates safe methods to combine high definition liposuction with abdominoplasty as well as demonstrating a technique for neoumbilicoplasty, which provides a more consistent and natural umbilical shape in the postoperative result.

High definition liposuction is a procedure that not only allows the reduction of fatty deposits but provides the surgeon the ability to sculpt the torso and back to enhance individual muscle definition. The procedure requires a knowledge of muscular anatomy such that fat removal provides etching of muscular boundaries, and in conjunction with autologous volume addition, allows the creation of both muscular definition and overall artistic shaping in body contour surgery. This video demonstrates the preoperative analysis and intraoperative technique required to produce consistent results in high definition liposuction.

Preoperative markings are demonstrated on the patient. From "Getting the Most Out of Augmentation Mastopexy" Plastic and Reconstructive Surgery: November 2018 – 142(5). CME.
Keywords: augmentation mastopexy, augmentation, mastopexy,

The double-crown technique as applied to vertical panniculectomy is demonstrated in this video. From "Complex Open Abdominal Wall Reconstruction: Management of the Skin and Subcutaneous Tissue." Plastic and Reconstructive Surgery: September 2018- 142 (3S).

In his open approach to a primary rhinoplasty patient with complex mid-vault and tip projection and shaping problems, Rod J. Rohrich, MD demonstrates how plastic surgeons can develop specific management pathways or algorithms for treating mid-vault problems, tip projection, and shaping issues in a methodical manner to obtain more consistent, good results in this complex procedure in plastic surgery.

In his open approach to a primary rhinoplasty patient with complex mid-vault and tip projection and shaping problems, Rod J. Rohrich, MD demonstrates how plastic surgeons can develop specific management pathways or algorithms for treating mid-vault problems, tip projection, and shaping issues in a methodical manner to obtain more consistent, good results in this complex procedure in plastic surgery.

Dr. Wall lays out the basis for his concepts of Separation, Aspiration, and Fat Equalization (SAFE) and Expansion Vibration Lipofilling (EVL), describing how tissue equilibration forms the basis of SAFE. He describes specific advances and offshoots of SAFE concepts and how they are utilized in achieving better outcomes in aesthetic surgery of the breasts, body, face, and buttocks.

In this video the MACS-lift is presented as the cornerstone of our current concept of comprehensive facial rejuvenation. It effectively and safely treats the aging of the lower half of the face and the upper neck in the majority of aging men and women. The addition of microfat grafting to treat the age-related centrofacial deflation adds to the power and longevity of the rejuvenation, and also allows treatment of non-age-related features such as the tear trough and the nasolabial fold. To treat the category of patients with a more demanding neck laxity, platysmal bands and submental fat deposition we can add a subplatysmal fat resection via a submental incision, and/or a posterior subplatysmal neck plasty with posterior platysma suspension. All of these techniques are included in detail in this video, together with some theoretical considerations.

This lecture discusses long term results achieved from dual plane mastopexy augmentation. This video demonstrates the indications and surgical technique for performing sub glandular augmentation with mastopexy. Strategies to reduce complications and optimize cosmetic results will be discussed.

Subpectoral placement of implants and the use of textured implants, while having definite advantages, also have drawbacks which, on occasion, can be detrimental to the patient. This video describes the problems seen with these choices and alternatives that may be implemented to ameliorate these problems.

The indications for surgical treatment of labia minora and labia majora are discussed. Patient selection, technical details of surgery, and management of expectations are important and reviewed in the presentation. The potential for aesthetic and functional improvements with non-invasive laser and radiofrequency devices are discussed with attention to efficacy versus surgical intervention.

Video demonstrates the efficient five step technique for internal mammary vessel preparation as a recipient site for breast reconstruction. From "Five Steps to Internal Mammary Vessel Preparation in Less than Fifteen Minutes." Plastic and Reconstructive Surgery: November 2017 - 140 (5).

This lecture focuses on the use of the periareolar mastopexy in aesthetic breast surgery. The presentation focuses on indication, surgical techniques and procedure, demonstrates many results, and discusses associated complications.

In a step-wise fashion, this video demonstrates the technical surgical sequence in performing a simultaneous Augmentation Mastopexy. This video demonstrates “pearls” to achieving longtime success safely. Part 1 of 2.

In a step-wise fashion, this video demonstrates the technical surgical sequence in performing a simultaneous Augmentation Mastopexy. This video demonstrates “pearls” to achieving longtime success safely. Part 2 of 2.

This video illustrates preoperative aesthetic analysis which formulates a surgical treatment plan that is patient specific. The operative demonstration focuses on the use of both SMAS plication techniques as well as an extended SMAS flap to reposition facial fat into the upper lateral cheek, restoring symmetrical cheek contour and providing for a natural-appearing youthful facial shape.
Part 1 of 3.
Baker Gordon Symposium on Cosmetic Surgery.
Keywords: Cosmetic; Face lift; Lipo filling; SMAS; Fat; Cheek

This video illustrates preoperative aesthetic analysis which formulates a surgical treatment plan that is patient specific. The operative demonstration focuses on the use of both SMAS plication techniques as well as an extended SMAS flap to reposition facial fat into the upper lateral cheek, restoring symmetrical cheek contour and providing for a natural-appearing youthful facial shape.
Part 2 of 3.
Baker Gordon Symposium on Cosmetic Surgery.
Keywords: Cosmetic; Face lift; Lipo filling; SMAS; Fat; Cheek

This video illustrates preoperative aesthetic analysis which formulates a surgical treatment plan that is patient specific. The operative demonstration focuses on the use of both SMAS plication techniques as well as an extended SMAS flap to reposition facial fat into the upper lateral cheek, restoring symmetrical cheek contour and providing for a natural-appearing youthful facial shape.
Part 3 of 3.
Baker Gordon Symposium on Cosmetic Surgery.
Keywords: Cosmetic; Face lift; Lipo filling; SMAS; Fat; Cheek

This video is from the 34th Annual Baker and Gordon Symposium on Cosmetic Surgery in 2000. During this procedure, Dr. Jelks describes his approach to upper and lower blepharoplasty, including the transconjunctival approach to contouring lower lid fat. The anatomy and technical nuances of retinacular canthopexy are demonstrated.

This video demonstrates the technical details of abdominoplasty combined with correction of rectus diastasis and abdominal liposuction to improve abdominal wall contour. Refinements in incision planning and the technical execution of brachioplasty are also presented. Considerations regarding aesthetic treatment planning and methods to avoid complications in both of these procedures are discussed.

This video demonstrates the technical details of abdominoplasty combined with correction of rectus diastasis and abdominal liposuction to improve abdominal wall contour. Refinements in incision planning and the technical execution of brachioplasty are also presented. Considerations regarding aesthetic treatment planning and methods to avoid complications in both of these procedures are discussed.

This video demonstrates Dr. Wu’s Microbotox injection technique for the lower face and neck. Microbotox is the injection of multiple microdroplets of diluted OnabotulinumtoxinA into the dermis or the interface between the dermis and the superficial layer of facial muscles. The intention is to decrease sweat and sebaceous gland activity in order to improve skin texture and sheen as well as to target the superficial layer of muscles that find attachment to the undersurface of the dermis causing visible rhytids. From the PRS supplement, “Soft Tissue Fillers and Neuromodulators: International and Multidisciplinary Perspectives” (vol 136, issue 5s). The techniques presented in this supplement to Plastic and Reconstructive Surgery do not necessarily represent best practices or endorsed techniques of the Guest Editors, Editor-in-Chief, Editorial Board, American Society of Plastic Surgeons (ASPS) or Wolters Kluwer Health. The videos in this supplement are intended to provide multidisciplinary, international perspectives on how specific Soft Tissue Filler and Neuromodulator products are being used by board-certified plastic surgeons, dermatologists, facial plastic surgeons, and oculoplastic surgeons worldwide and may contain off-label uses in your region. It is recommended that these techniques only be administered by board-certified physicians who are core-trained in cosmetic medicine and according to the product labeling recommended by the U.S. Food and Drug Administration. Publication of these supplements does not constitute product or sponsor endorsement by Journal or ASPS. Keywords: Cosmetic; Injectable; Botox; Face; Neck; Technique;

This video demonstrates highlights of facelift surgery including the use of tumescent infiltration, 500-700ccs of the face and neck, lipo-dissection (tunneling) of the neck for wide-undermining, and perforator preservation. The extended SMAS elevation typically avoids the need and is counterproductive to platysma plication. Finally, moderate volume fat grafting is critical for volume restoration and facial shaping. These procedures facilitate one another for an effective and efficient facelift.

Part 2 of 2. The postoperative contour deformity which can result following breast augmentation can be difficult surgical problems. Traditional approaches of capsulectomy and implant change are commonly followed by recurrent contour deformity. The ability to control the interface between implant and breast soft tissue with the use of acellular dermal matrix and autologous fat, which serves as a regenerative matrix, provides a surgical solution for the difficult reoperative breast augmentation patient. This lecture will focus on long term solutions for these difficult problems.

This video demonstrates the markings for the boomerang pattern excision of gynecomastia combined with the J-torsopolasty, followed by the critical moments of the operation in a 24 year old massive weight lost patient, who had a prior abdominoplasty with oblique excision extension over his flanks . From “Boomerang Correction of Gynecomastia.” Issue #2 2015. Plastic and Reconstructive Surgery. Keywords: Cosmetic; Gynecomastia; Torsoplasty; Management;

Part 1 of 4. This video focuses on the use of autogenous fat transfer in gluteal augmentation in combination with zonal circumferential liposuction. Utilizing the aspirated fat to perform autogenous gluteal augmentation is demonstrated.

Part 3 of 4. This video focuses on the use of autogenous fat transfer in gluteal augmentation in combination with zonal circumferential liposuction. Utilizing the aspirated fat to perform autogenous gluteal augmentation is demonstrated.

Part 2 of 2. Short scar neck lifting is a procedure that focuses on restoring cervical contour, and is indicated in younger patients who present with platysma banding not associated with facial laxity. The procedure is performed through a postauricular incision in combination with a submental incision, and involves platysmaplasty, the precise contouring of cervical fat, as well as excision of excess cervical skin. This video will focus on both the preoperative analysis, as well as operative technique in performing neck lifting.

Part 1 of 2. Mandatory outcomes in aesthetic surgery are driven by the avoidance of complications. This lecture highlights those technical maneuvers that allow ADM’s to be used in aesthetic surgery safely.

Part 3 of 3. This video demonstrates a circumferential truncal rejuvenation procedure by performing by incorporating a full abdominoplasty with excision of sub-Scarpal fat, concurrently with circumferential SAFELipo. The three-step process of SAFELipo allows complete, circumferential liposuction of the entire trunk including the area of the abdominoplasty flap, without disrupting the vascular supply of the flap. Excision of the sub-Scarpal fat of the abdominoplasty flap eliminates the parasitic deep fat, decreasing the metabolic load on the flap. These techniques allow for a circumferential rejuvenation of the entirety of the trunk while minimizing complications.

Part 1 of 4. These videos examine the author’s experience utilizing autologous fat transfer for contour restoration in reconstructive breast surgery, as well as in the reoperative breast augmentation patient. Included is a video demonstration of the author’s technique for secondary breast augmentation utilizing autologous fat transfer in conjunction with implant change. Suture suspension of the breast to define the inframammary crease, as well as to support the ptotic breast is demonstrated.

Part 1 of 4. This video demonstrates surgical correction of vertical bands on the anterior neck with muscle approximation and wedge resection of platysma below the level of suturing. A lateral platysma flap is created to enhance the jaw line and the SMAS is treated by transverse high plication

Part 2 of 4. This video demonstrates surgical correction of vertical bands on the anterior neck with muscle approximation and wedge resection of platysma below the level of suturing. A lateral platysma flap is created to enhance the jaw line and the SMAS is treated by transverse high plication

Part 3 of 4. This video demonstrates surgical correction of vertical bands on the anterior neck with muscle approximation and wedge resection of platysma below the level of suturing. A lateral platysma flap is created to enhance the jaw line and the SMAS is treated by transverse high plication

Part 1 of 2. This video presents a vertical reduction technique that uses a superior pedicle. This procedure is well suited to small to moderate size reductions. Marking, resection, closure, and NAC placement concepts are illustrated.

Part 1 (of 3) of a video that demonstrates the Extended SMAS technique in facial rejuvenation as well as utilizing the submental approach to anterior plastymaplasty. Facial subcutaneous anatomy delineating the fat compartments of the cheek during subcutaneous undermining is demonstrated, as well as the relationship of the transition between fat compartments and the location of the retaining ligaments. Relevant anatomy to provide safety during subsmas dissection of the cheek is emphasized.
Baker Gordon Symposium on Cosmetic Surgery. Keywords: Cosmetic; Rhytidectomy; Face lift; Extended SMAS

Part 2 (of 3) of a video that demonstrates the Extended SMAS technique in facial rejuvenation as well as utilizing the submental approach to anterior plastymaplasty. Facial subcutaneous anatomy delineating the fat compartments of the cheek during subcutaneous undermining is demonstrated, as well as the relationship of the transition between fat compartments and the location of the retaining ligaments. Relevant anatomy to provide safety during subsmas dissection of the cheek is emphasized.
Baker Gordon Symposium on Cosmetic Surgery. Keywords: Cosmetic; Rhytidectomy; Face lift; Extended SMAS

Part 3 (of 3) of a video that demonstrates the Extended SMAS technique in facial rejuvenation as well as utilizing the submental approach to anterior plastymaplasty. Facial subcutaneous anatomy delineating the fat compartments of the cheek during subcutaneous undermining is demonstrated, as well as the relationship of the transition between fat compartments and the location of the retaining ligaments. Relevant anatomy to provide safety during subsmas dissection of the cheek is emphasized.
Baker Gordon Symposium on Cosmetic Surgery. Keywords: Cosmetic; Rhytidectomy; Face lift; Extended SMAS

There are millions of women in the USA who received saline implants during the FDA moratorium on silicone gel devices. Many of these patients are approaching middle age. Saline implants, often over-filled to avoid rippling, may cause undo pressure on the overlying soft tissue and lead to parenchymal thinning. In this patient population, the resultant convexity of the upper pole may not be well tolerated. An approach that may be of benefit in the future is implant exchange with fat overlay- the so-called composite or bilamellar breast augmentation revision

This primary rhinoplasty done via an open approach demonstrates the component dorsal reduction approach to rhinoplasty and it exemplifies the use and role of invisible grafts such as a columellar strut graft to reshape the nasal tip area. Non-destructive suture techniques are used to reshape and refine the nasal tip. Alar contour grafts are used to prevent long term alar rim collapse in the primary open rhinoplasty patient. All these techniques can be used in most primary rhinoplasty patients with excellent reproducible outcomes.
Baker Gordon Symposium on Cosmetic Surgery. Keywords: Cosmetic; Rhinoplasty; Primary; Grafts

This 4-part video highlights the markings and surgical technique involved in using the circumvertical pattern for management of the residual breast parenchyma and skin left over after explantation. Operative steps and tips for success are presented including the use of the interlocking PTFE suture technique for management of the periareolar closure.

This four-part video demonstration is of an isolated neck lift, a procedure indicated in patients with cervical obliquity and bands, in which the soft tissues of the cheek and jawline are well supported by the facial retaining ligaments. I perform isolated neck lifts through postauricular incisions, as well as a submental incision which allows access to contouring the anterior platysma. The dissection is begun laterally through the postauricular incision towards the midline of the neck, dissecting in the subcutaneous plane along the innerface between preplatysmal fat and the underlying platysma muscle. This allows the surgeon to keep the preplatysmal fat intact and vascularized on the cervical skin flap. After performing a similar dissection on the contralateral side, a submental incision is made caudal to the submental skin crease, and the dermal attachments of the crease are dissected from the mandibular symphysis. A through-and-through dissection of the neck is then completed. Preplatysmal fat is removed from the central neck to expose the underlying platysma muscle. In the patient on this video, a small amount of subplatysmal fat is also resected superior to the hyoid, to deepen the cervicomental angle. Interrupted 3-0 mersilene sutures are used for the platysma plication, extending from the mentum toward the base of the neck. A partial platysma myotomy is then performed from the midline toward the anterior border of the sternocleidomastoid, a distance of 5 to 6 cms. The key to platysma transection is not only to divide the muscle, but also to release the superficial fascia posterior to the platysma, to ensure adequate muscular release. Following platysma myotomy, the platysmaplasty is reinspected and additional sutures are added to define the cervicomental angle.
In summary, the advantages of an anterior approach to cervical contouring include:
1) Direct surgical access to the anterior platysma, allowing the surgeon to precisely contour the platysma muscle such that it conforms to the floor of the mouth and thyroid cartilage, thereby diminishing cervical obliquity and banding.
2) It allows the surgeon to precisely set the depth of the cervicomental angle, which is of aesthetic significance in determining both the vertical height of the neck, as well as the horizontal dimension of the jawline.
3) Precise resection of preplatysmal and subplatysmal fat
4) The obliteration of the submental crease, which allows a better blending between the chin and the neck.
Baker Gordon Symposium on Cosmetic Surgery. Keywords: Cosmetic; Neck lift; Platysmaplasty; Technique